Four Corner Fusion using Medartis plate and scaphoid excision


Subscribe to get full access to this operation and the extensive Upper Limb & Hand Surgery Atlas.


CPD/CME Points: 1

This is a detailed step by step instruction through a Four Corner fusion and scaphoid excision using a dorsal low profile titanium plate from MedartisTM.

This is a salvage operation usually undertaken when the scaphoid fossa is damaged and arthritic most commonly from a Scaphoid non-union advanced collapse (SNAC ) stage 2 and above or Scapholunate advanced collapse (SLAC) stage 2 and above. Rarely it can also be undertaken in the acute setting with complex carpal injuries and dislocations.

Following a period of 6-8 weeks in plaster cast and the rehabilitation it is expected the patient will achieve 30-50% of their normal range of movement. The operation has a non-union rate of around 10%


Author: Mr Mark Brewster FRCS (Tr & Orth)

Institution: The Royal Orthopaedic Hospital, Birmingham, UK.



Associates & Partners

Logo Logo Logo Logo Logo